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38 Cards in this Set
- Front
- Back
the ratio of the density of a substance to the density of another substance accepted as a standard. The usual standard for liquids and solids is water. Thus a liquid or solid with a specific gravity of 4 is four times as dense as water at the same temperature. Hydrogen is the usual standard for gases.
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Specific Gravity
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○ a measure of the amount of urea in the blood. Urea forms in the liver as the end product of protein metabolism, circulates in the blood, and is excreted through the kidney in urine. The BUN, determined by a blood test, is directly related to the metabolic function of the liver and the excretory function of the kidney. Normal findings (in mg/dL) are 10 to 20 for adults, 5 to 18 for children and infants, 3 to 12 for newborns, and 21 to 40 for cord blood. In the elderly, the BUN may be slightly higher than the normal adult range. A critical value of 100 mg/dL indicates serious impairment of renal function.
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BUN Blood Test
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○ a substance formed from the metabolism of creatine, commonly found in blood, urine, and muscle tissue. It is measured in blood and urine tests as an indicator of kidney function. Normal adult blood levels of creatinine are 0.5 to 1.1 mg/dL for females and 0.6 to 1.2 mg/dL for males; the numbers decrease in elderly patients because of a smaller muscle mass.
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Creatinine
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○ a diagnostic test for kidney function. It measures the rate at which creatinine is cleared from the blood by the kidney. It is calculated on the basis of a urine volume in milliliters per minute times the amount of milligrams per liter of urinary creatinine excreted in 24 hours. The resulting figure is divided by the amount of serum creatinine in milligrams per deciliter.
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Creatinine Clearance Test
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Crystals, protein, or other substances
Classified by minerals comprising the stone Most common: Calcium oxalate or phosphate 70% Struvite 15% Uric acid 7% |
Renal Calculi/Stones
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Age, gender, race, geographic location (hard water), seasonal factors, fluid intake, diet, occupation
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Risk Factors for Renal Calculi/Stones
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Supersaturation of one or more salts
Precipitation of a salt from liquid to solid state Growth into a stone via crystallization or aggregation |
Kidney stone formation
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Moderate to severe pain-flank area radiating to groin
Colic pain, urgency, frequent voiding, urge incontinence |
Clinical Manifestation of Kidney Calculi/Stones
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Stone and UA analysis
Intravenous pyelogram (IVP) Kidney, Ureter, Bladder x-ray Spiral abdominal CT |
Evaluation of Kidney Calculi/Stones
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5th most common malignancy
more common >60 years |
Bladder tumors
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Increased incidence with smoking
Genetic alteration in normal bladder epithelium |
Patho of bladder tumors
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Gross painless hematuria
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#1 clinical symptom of bladder tumors
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Bothersome lower urinary tract symptoms: frequency, nocturia, urgency, urge incontinence
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Clinical manifestations of bladder tumors
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Inflammation of urinary epithelium from pathogen
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Urinary Tract Infection
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Bacteria most common that causes UTI
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E. Coli
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Inflammation of the bladder
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Cystitis
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Frequency, dysuria, urgency, lower abdominal pain/suprapubic pain
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Clinical Manifestations of cystitis
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Dysuria, frequency, suprapubic and lower back pain, foul smelling, cloudy
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Young Adult Clinical Manifestations of UTI
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Confusion, abdominal discomfort, higher infection rate so microorganisms proliferate
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Older Adult Clinical Manifestations of UTI
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Inflammation of glomerulus
Most common cause of chronic and end-stage renal disease |
Glomerulonephritis
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Immunological abnormalities
Ischemia:vascular disorders Free radicals Drugs or toxins Systemic diseases |
Causes of glomerulonephritis
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Deposition of circulating soluble antigen-antibody complexes, often with complement fragments
Formation of antibodies against the glomerular basement membrane Streptococcal release of neuramidase |
Mechanisms of injury
glomerulonephritis |
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Streptococcal infection
Begins abruptly; 7 to 10 days after strep infection |
Acute Glomerulonephritis
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Several diseases leading to chronic renal failure
Assoc with hypercholesterolemia and proteinuria |
Chronic Glomerulonephritis
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Dev over days to weeks
Affects adults 5 decade Idiopathic or assoc with proliferative glomerular disease Renal insufficiency; poor prognosis if untreated early |
Rapidly progressive
Goodpasture syndrome |
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Hematuria, RBC casts, proteinuria, decreased GFR, oliguria, HTN, edema of eyes or feet/ankles
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Clinical manifestations of acute glomerulonephritis
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Hematuria and proteinuria
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Clinical manifestations of chronic glomerulonephritis
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Excretion of 3.5 g or more of protein in the urine per day
The protein excretion is caused by glomerular injury |
Nephrotic Syndrome
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Hypoalbuminemia, edema, hyperlipidemia, lipiduria, and vitamin D deficiency
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Nephrotic Syndrome
Findings |
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Decline in renal function to 25% of normal
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Renal insufficiency
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Significant loss of renal function
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Renail failure
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<10% of renal function remains
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End-stage renal failure (ESRD)
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Abrupt reduction in renal function
BUN and creatinine Oliguria; but may be normal Most types are reversible; if treated early |
Acute Renal Failure
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Impaired renal blood flow (most common cause)
GFR declines due to ê filtration pressure |
Prerenal Acute Renal Failure
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Tubular necrosis; surgery sepsis, obstruction
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Intrarenal Acute Renal Failure
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Urinary tract obstruction (bilateral)
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Postrenal Acute Renal Failure
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Progressive and irreversible loss of nephrons
GFR; affects all organ systems Does not become apparent until < 25% function remains |
Chronic Renal Failure
End-Stage Renal Disease (ESRD) |
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Uremia/azotemia
Accumulation of toxins in plasma HTN, anorexia, nausea, vomiting, diarrhea, weight loss, pruritus, edema, anemia, and neurologic changes |
Clinical manifestation of chronic renal failure
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